“What if”—Two words that are breaking emergency medicine

Emergency medicine in the UK and across the world is in trouble. This is not news, I know. We’re overwhelmed with patients, corridors are now clinical areas, and some days the patients in the queue for a bed have waited so long they’ve formed their own WhatsApp group. But behind the bed shortages and system collapse, there’s a quieter problem eating away at our specialty and it’s only two words long: What if.What if that headache is a subarachnoid? What if this chest pain is an aortic dissection? What if the thing that looks like a viral illness turns out to be something I’ve only seen once before and missed this time, and I get sued and referred to the GMC and fired and . . . you get the idea.This short, seemingly sensible phrase lurks behind many of our decisions. Because we’re all terrified—of missing something rare, of complaints,…